HomeMy WebLinkAboutMN Dept lavor/Industry-initial application ' 7 }v
Minnesota Department of Labor and Industry
Construction Codes and Licensing Division . .1.Building Plan Review ) 'MINNESOTA DEPARTMENT or
443 Lafayette Road North r Y Nt,BO R 8C INDUSTRY ,
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St. Paul,MN 55155 cC
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Phone: (651)284-5857 CPF,t...:-'.::a -0"tias 411i
www.dli.mn.gov/CCLD/PlanConstruction.asp .r t it /,0 nitial Application 6-2p,
e RO`ECTIN CATION
PROJECT TITLE �.__1--%% PROJECTED CONSTRUCTION VALUATION`'-)
Orono High School 2015 Fire alarm Upgrade $115,000
PROJECT LOCATION(number and street name) COUNTY
795 Old Crystal Bay Road North Hennepin
PROJECT CITY or PROJECT TOWNSHIP (Enter only the city or township,not both) ❑Check if outside city limits
Orono
OWNER(OR STATE AGENCY IF APPLICABLE) (OR ISD#IF APPLICABLE) CONTACT PERSON
Independent School District#278 Justin McCoy
ADDRESS PHONE
685 Old Crystal Bay Road North (612)217-3677
CITY ' STATE ZIP CODE E-MAIL
Orono i MN ,55356 jmccoy@orono.k12.mn.us
DESIGN FIRM PROJECT CONTACT
Wold Architects & Engineers Nick Marcucci
ADDRESS PHONE
305 St. Peter Street (651) 227-7773
CITY STATE ZIP CODE E-MAIL
Saint Paul MN 55102 nmarcucci@woldae.com
PROJECT TYPE
(As defined by MN Statute 326B.103 Subd.11 and Subd.13)
O State Owned-A building and its grounds the cost of which are paid for by the state or state agency regardless of its cost.
Q✓ Public School District-A school district building project or charter school building project,the cost of which is$100,000 or more.
State Licensed Facilit A building and its grounds that are licensed by the state as a:
0 hospital, LI nursing home, 0 supervised living facility, 0 free-standing outpatient surgical center,
0 correctional facility, ID boarding care, Q residential hospice.
If your project is not licensed specifically as listed above,the project is not under the jurisdiction of the Building Plan Review Unit.
CLASS OF WORK
❑ New Building Construction ❑Addition Q Remodeling Sprinklers 0 Yes 0 No Q Partial
LI Permit Only(submit documentation from regional building official) ANTICIPATED START DATE 06/08/2015
IBC OCCUPANCY CLASSIFICATION(S) IBC TYPE OF CONSTRUCTION
E. A-2.-6.13 IIB
PROJECT DESCRIPTION
Fire Alarm replacement
APPLICANT INFORMATION
Upon receiving this completed initial application,we will confirm proper jurisdiction for the project and assign a project number.We will notify
you in writing of the project number,where to submit your documents for review,and how inspections will be handled. If delegated to the
municipality, you will need to follow their procedures and fee schedule.Otherwise our standard application process will need to be followed.
I completed the information on this application and understand that i does not authorize the start of construction.
APPLICANT NAME(PRINT) APPLICANT Sl(.NA IRE DATE PHONE
Nicholas Marcucci I 02/16/2015 (651)227-7773
APPLICANT 305 St. Peter Street AILING ADDRESS ISa nt P..�' MNSTATE 55102 I nmarcucci@woldae.com
FOR OFFICE USE ONLY r�'- 1�
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This material can be made available In different fins. ,. request,call 1-800-342-5354(DIAL-DLI). /
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